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Medicine 3 > Mock Questions > Flashcards

Mock Questions Flashcards

1
Q

Are minor salivary glands encapsulated in connective tissue?

A

No

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2
Q

Describe the embryological development of the midgut

A

Rotates around the axis of the developing superior mesenteric artery

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3
Q

How much of total saliva production comes from the parotid glands?

A

~20%

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4
Q

Is acinar cell secretion hyper or hypotonic to plasma?

A

Hypotonic (due to reabsorption of NaCl)

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5
Q

Why do cystic fibrosis patients suffer from impaired fat digestion?

A

Cannot secrete bicarbonate ions - reduces effectiveness of digestive enzymes

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6
Q

Where is gastrin secreted from?

A

G cells lining stomach and upper small intestine

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7
Q

What are the actions of gastrin?

A

Stimulates stomach to release gastric acid, gallbladder to empty store of bile and pancreas to secret pancreatic enzymes. Also increases stomach motility

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8
Q

How do NSAIDs induce poetic ulceration?

A

Inhibit synthesis of cytoprotective-prostaglandins

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9
Q

What pharmacological treatment is used for IBS?

A

Tricyclic antidepressants (amitriptyline)

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10
Q

What is Zollinger-Ellison syndrome?

A

Gastrin secreting tumour of G cells resulting in peptic ulcers

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11
Q

A construction worker presents with profuse vomiting two hours after buying and eating a sandwich from a catering van. Which organism is most likely to be responsible for his symptoms?

A

Staphylococcus aureus - enterotoxin with rapid effect when ingested

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12
Q

Why intravenous antibiotics less effective for treatment of Clostridium difficile disease than oral antibiotics?

A

Oral antibiotics more effective as higher concentrations achieved in gut lumen

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13
Q

Which hepatitis virus contains a DNA genome?

A

Hepatitis B

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14
Q

Describe cholecystokinin?

A

Release stimulated by fat in duodenum.

Stimulates contractions of gallbladder and common bile duct - delivery of bile to gut

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15
Q

Describe secretin

A

Secreted in response to acid in duodenum.
Stimulates biliary duct cells to secrete bicarbonate and water - expands bile volume and increases outflow into intestine

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16
Q

Describe phase I of drug metabolism

A

Involves cytochrome P450-dependent mono-oxygenases

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17
Q

What is the recommended paracetamol dose?

What is defined as an overdose?

A

4g in 24 hours (or 75mg/kg)

Overdose = >4g (or >75mg/kg) in a period of <1 hour

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18
Q

How does paracetamol poisoning cause liver damage?

A

Through one of its metabolites (NAPQI)

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19
Q

What is the effect of dietary fibre on colonic transit time?

A

Speeds up transit time

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20
Q

What does dietary fibre cause in the large intestine?

A

Production of short-chain fatty acids

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21
Q

Describe the epithelium in the DCT, CD and ureter

A

Cuboidal epithelial cells with no microvilli

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22
Q

Is there any protein reabsorption in the kidney?

A

Yes in the proximal tubule (very little filtered but all reabsorbed by pinocytosis)

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23
Q

Which region of the nephron is relatively hypoxic?

A

The bottom of the loop of Henle

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24
Q

Where in the nephron is the tubular fluid isotonic to plasma?

A

Proximal tubule

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25
Q

Where in the nephron does the bulk reabsorption of K+ take place?

A

Proximal tubule

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26
Q

Is the fluid at the end of the thick ascending limb of the loop of Henle hypo or hypertonic?

A

Hypotonic

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27
Q

How long does it take for plasma bicarbonate levels to rise in response to acidosis?

A

A few days due to induction of the ammonium mechanism

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28
Q

What are the contraindications between furosemide and digoxin?

A

Furosemide can cause hypokalemia and low K+ can increase digoxin toxicity

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29
Q

Why is gout a reason to avoid using thiazide diuretics?

A

Because they can lead to an increased plasma urate

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30
Q

What is the embryological origin of the parathyroid glands?

A

The pouch of the 3rd and 4th pharyngeal arch

31
Q

What nerve leads to sympathetic inner action of the pancreatic islets?

A

Thoracic splanchnic nerves

32
Q

What is the relationship between prolactin and GnRH?

A

Prolactin inhibits hypothalamic GnRH

33
Q

In starvation, what is the fate of T4?

A

Conversion to rT3 rather than T3 to reduce metabolism and conserve resources

34
Q

Where is calcitonin secreted?

What is its effect?

A

Parafollicular C cells

Lowers plasma calcium

35
Q

Where is parathyroid hormone secreted?

What is its effect?

A

Parathyroid chief cells

Increase plasma calcium levels

36
Q

Why can diabetes mellitus be secondary to development of acromegaly?

A

Elevated GH can lead to impaired glucose homeostasis and diabetes

37
Q

How does a hyper-secreting adrenal medulla tumour lead to diabetes?

A

Adrenaline released, raising blood glucose

38
Q

What are somatotrophs?

A

Cells of anterior pituitary that produce GH

39
Q

What is the relationship between cortisol and glycogen?

A

Cortisol expands glycogen stores (in prolonged stress) and causes gluconeogenesis

40
Q

How long do anti-thyroid drugs take to have an effect?

A

Several weeks due to large stores of TH in thyroid gland

41
Q

How would you diagnose Addison’s disease?

A

Lack of response to Synacthen (synthetic ACTH) test. Confirms adrenal hyposecretion

42
Q

What is the effect of activating the glucagon receptor?

A

Increased intracellular cAMP

43
Q

Where are spermatogonia found?

A

Seminiferous tubules

44
Q

Where does lymph drainage from the medial part of the tongue body go?

A

Inferior deep cervical lymph nodes

45
Q

Give 3 things that increase gastric acid secretion

A

Activation of vagus nerve
Action of ACh on enterochromaffin-like cells
Presence of food in mouth

46
Q

Where is the majority of protein digested?

A

Stomach

47
Q

Describe the autocatabolistic effect of trypsin

A

Trypsin acts on trypsinogen to generate more trypsin for proteolysis

48
Q

What increases intestinal motility?

A

Muscarinic receptor activation by ACh

Increased stretch of small intestinal smooth muscles

49
Q

What is hepatic encephalopathy?

A

Damage to the brain from chronic liver failure

50
Q

How does oral rehydration therapy for diarrhoea work?

A

Glucose present promotes sodium absorption via a symporter

51
Q

What provides symptomatic relief in diarrhoea management?

A

Opioid receptor agonist (loperamide)

52
Q

What are the side effects of tricyclic antidepressants such as amitriptyline?

A

Constipation due to anti-muscarinic side effects

53
Q

What is first pass metabolism?

A

Removal of the drug before it enters systemic circulation

54
Q

What do different isoforms of cytochrome P450-dependent mono oxygenases show?

A

Significant genetic variation

55
Q

How does reduced cardiac output lead to oedema?

A

Reduced blood volume is detected and fluid retention occurs

56
Q

What is the process of release of TSH from anterior pituitary?

A

Exocytisis

57
Q

What is the process of movement of colloid into thyroid follicular cell?

A

Endocytosis

58
Q

What is the process involved in the release of cortisol form adrenal cortex cells?

A

Simple diffusion

59
Q

What is the vascular supply to the pituitary?

A

Superior and inferior hypophyseal arteries

60
Q

What does a lack of dietary iodine result in?

A

Goitre (enlarged thyroid gland) due to reduced TH and less negative feedback of TSH

61
Q

Why is the thyroid gland enlarged in hypothyroidism?

A

Lack of TH reduces negative feedback of TSH

62
Q

What type of nerve fibres innervate the adrenal medulla?

A

Preganglionic

63
Q

What hormones act synergistically in the stress response?

A

GH and cortisol to increase lipolysis

64
Q

What effect does Cushing’s syndrome have on bones?

A

Can cause osteoporosis

65
Q

What is the relationship between Cushing’s syndrome and diabetes?

A

Cushing’s can lead to diabetes - elevated glucocorticoids lead to impaired glucose homeostasis

66
Q

What dietary advice should be given to someone with type 2 diabetes?

A

Dietary cholesterol intake less than 200mg per day

67
Q

What is the effect of leptin?

A

Reduction in food intake - appetite suppressant

68
Q

What is Prader-Willi syndrome?

A

Genetic condition that causes excessive appetite and overeating leading to obesity

69
Q

How would you test for GH tumour?

A

Oral glucose test - suppressed GH release normally so lack of response = positive result

70
Q

How long into gestation until fetus can synthesise thyroid hormone?

A

12 weeks

71
Q

What is the role of Leydig cells?

A

Secrete testosterone in the presence of LH

72
Q

What is the average loss of life expectancy in lifelong regular smokers?

A

10 years

73
Q

What is the most effective treatment to stop smoking?

A

Agonist of nicotinic acetylcholine receptor (varenicline)

Medicine 3 (8 decks)

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